carboplatin


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carboplatin

 [kahr″bo-plat´in]
a platinum coordination compound that interferes with functioning of cellular DNA; used as an antineoplastic agent to treat cancers of the ovary, lung, head and neck, testes, bladder, brain, and other organs.

carboplatin

Pharmacologic class: Alkylating agent

Therapeutic class: Antineoplastic

Pregnancy risk category D

FDA Box Warning

• Give under supervision of physician experienced in cancer chemotherapy, in facility with adequate diagnostic and treatment resources.

• Bone marrow suppression is dose-related and may be severe, resulting in infection and bleeding. Anemia may be cumulative and warrant transfusions.

• Vomiting is a common adverse effect.

• Anaphylactic-like reactions may occur within minutes of administration.

Action

Inhibits DNA synthesis by causing cross-linking of parent DNA strands; interferes with RNA transcription, causing growth imbalance that leads to cell death. Cell-cycle-phase nonspecific.

Availability

Injection: 50-mg, 150-mg, and 450-mg vials

Indications and dosages

Initial treatment of advanced ovarian cancer or palliative treatment of ovarian cancer unresponsive to other chemotherapeutic modalities

Adults: Initially, 300 mg/m2 I.V. (given with cyclophosphamide) at 4-week intervals. For refractory tumors, 360 mg/m2 I.V. as a single dose; may be repeated at 4-week intervals, depending on response. However, single dose shouldn't be repeated until neutrophil count is at least 2,000/mm3 and platelet count at least 100,000/mm3. Subsequent dosages are based on blood counts.

Dosage adjustment

• Renal impairment

• Reduced bone marrow reserve

Off-label uses

• Advanced endometrial cancer

• Advanced or recurrent squamous cell carcinoma of head and neck

• Relapsed and refractory acute leukemia

• Small-cell lung cancer

• Testicular cancer

Contraindications

• Hypersensitivity to drug, cisplatin, or mannitol

• Pregnancy or breastfeeding

Precautions

Use cautiously in:

• hearing loss, electrolyte imbalances, renal impairment, active infections, diminished bone marrow reserve

• females of childbearing age.

Administration

• Premedicate with antiemetics, as prescribed.

• When preparing and administering drug, follow facility protocol for handling cytotoxic drugs.

• Reconstitute powder for injection by adding sterile water for injection, 0.9% sodium chloride injection, or 5% dextrose injection, as appropriate, to provide 10-mg/ml solution. Drug may be further diluted to concentrations as low as 0.5 mg/ml.

• Don't use with needles or I.V. sets containing aluminum.

• Administer I.V. infusion over at least 15 minutes.

• Make sure patient maintains adequate fluid intake.

• Know that drug is given in combination with other agents.

Adverse reactions

CNS: weakness, dizziness, confusion, peripheral neuropathy, cerebrovascular accident

CV: heart failure, embolism

EENT: visual disturbances, ototoxicity

GI: nausea, vomiting, constipation, diarrhea, abdominal pain, stomatitis

GU: gonadal suppression, nephrotoxicity

Hematologic: anemia, leukopenia, thrombocytopenia, neutropenia Hepatic: hepatitis

Metabolic: hypocalcemia, hypokalemia, hypomagnesemia, hyponatremia

Respiratory: bronchospasm

Skin: alopecia, rash, urticaria, erythema, pruritus

Other: altered taste, hypersensitivity reactions, anaphylaxis

Interactions

Drug-drug. Live-virus vaccines: decreased antibody response to vaccine, increased risk of adverse reactions

Myelosuppressants: additive bone marrow depression

Nephrotoxic or ototoxic drugs (such as aminoglycosides, loop diuretics): additive nephrotoxicity or ototoxicity

Phenytoin: decreased phenytoin blood level

Drug-diagnostic tests. Alkaline phosphatase (ALP), aspartate aminotransferase (AST), blood urea nitrogen, creatinine: increased values

Electrolytes, hematocrit, hemoglobin. neutrophils, platelets, red blood cells, white blood cells: decreased values

Patient monitoring

• Assess for signs and symptoms of hypersensitivity reactions.

• Monitor CBC to help detect drug-induced anemia and other hematologic reactions.

• Monitor ALP, AST, and total bilirubin levels.

• Evaluate fluid and electrolyte balance.

Patient teaching

• Instruct patient to report signs and symptoms of allergic response and other adverse reactions, such as breathing problems, mouth sores, rash, itching, and reddened skin.

• Advise patient to report unusual bleeding or bruising.

• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.

• Urge patient to avoid activities that can cause injury. Advise him to use soft toothbrush and electric razor to avoid gum and skin injury.

• Instruct patient to drink plenty of fluids to ensure adequate urinary output.

• Provide dietary counseling and refer patient to dietitian as needed if GI adverse effects significantly limit food intake.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

car·bo·plat·in

(kar'bō-pla-tin),
A platinum-containing anticancer agent much like cisplatin but more toxic to the myeloid elements of bone marrow while producing less nausea and neuro-, oto-, and nephrotoxicity; used in the chemotherapy of solid tumors.

carboplatin

(kär′bō-plăt′n)
n.
A platinum-containing chemotherapeutic drug used primarily in the treatment of advanced ovarian cancer.

carboplatin

A chemotherapeutic agent used to manage advanced ovarian, lung, head and neck and other cancers; it interacts with DNA in a manner similar to that of alkylating agents.

Adverse effects
Myelosuppression, nausea, vomiting diarrhoea, hair loss, pain, neurologic complaints.

carboplatin

Oncology A chemotherapeutic for advanced ovarian and other CAs Adverse effects Cytopenias, nausea, diarrhea, hair loss, pain, neurologic complaints

car·bo·plat·in

(kahr'bō-plat'in)
A platinum-containing anticancer agent much like cisplatin but more toxic to the myeloid elements of bone marrow while producing less nausea and neuro-,oto-, and nephrotoxicity; used in the chemotherapy of solid tumors.

carboplatin

An anticancer drug. A brand name is Paraplatin.
References in periodicals archive ?
In 2017, Merck received US FDA's accelerated approval for the combination of pembrolizumab with ALIMTA and carboplatin for the first-line treatment of metastatic nonsquamous NSCLC based on data from its KEYNOTE-021 study, Cohort G1.
After 2 years of follow-up, 25% of the ovarian cancer patients in the cisplatin group had residual neurotoxic effects, while "almost all patients in [the carboplatin group] had recovered," said Dr.
In KEYNOTE-407, Keytruda in combination with carboplatin and either paclitaxel or nab-paclitaxel significantly improved OS, reducing the risk of death by 36% compared to chemotherapy alone (HR=0.64 [95% CI, 0.49-0.85]; p
"Positive efficacy and safety data with belinostat and carboplatin and paclitaxel (BelCaP) in patients with platinum-resistant ovarian cancer have previously been announced by TopoTarget," CEO Peter Jensen said.
At this interim analysis, the combination of Tecentriq plus carboplatin and paclitaxel (Arm A) did not show a statistically significant OS benefit when compared to the combination of Avastin plus carboplatin and paclitaxel (Arm C).
The Phase III IMpower150 study has achieved its co-primary endpoint of overall survival at the interim analysis and indicated that combined lung cancer treatment helped people with advanced non-squamous non-small cell lung cancer to live significantly longer compared with Avastin plus carboplatin and paclitaxel.
- The US Food and Drug Administration has approved US-based biopharmaceutical company Merck's (NYSE: MRK) Keytruda anti-PD-1 therapy, in combination with carboplatin and either paclitaxel or nab-paclitaxel, for the first-line treatment of patients with metastatic squamous non-small cell lung cancer (NSCLC) based on results from the KEYNOTE-407 trial, Merck said.
The addition of KEYTRUDA to carboplatin plus paclitaxel or nab-paclitaxel chemotherapy also significantly improved progression-free survival, with a reduction in the risk of progression or death of nearly half for patients in the KEYTRUDA combination group, compared with chemotherapy alone.
Roche today announced that the Phase III IMpower131 study met its co-primary endpoint of progression-free survival (PFS) and demonstrated that the combination of TECENTRIQ (atezolizumab) plus chemotherapy (carboplatin and Abraxane albumin-bound paclitaxel; nab-paclitaxel ) reduced the risk of disease worsening or death (progression-free survival; PFS) compared with chemotherapy alone in the initial (first-line) treatment of people with advanced squamous non-small cell lung cancer (NSCLC).
The trial evaluated the combination of Keytruda, Lilly's pemetrexed and platinum chemotherapy made up of cisplatin or carboplatin as a first-line treatment of patients with metastatic non-squamous non-small cell lung cancer (NSCLC).
M2 PHARMA-October 24, 2018-Genentech's Tecentriq Plus Chemotherapy (Carboplatin and Abraxane) as an Initial Treatment Helped People With Advanced Non-Squamous Non-Small Cell Lung Cancer Live Significantly Longer Compared to Chemotherapy Alone
Genentech, a member of the Roche Group, announced that the Phase III IMpower150 study met its co-primary endpoint of overall survival, or OS, at this interim analysis and showed that initial treatment with the combination of TECENTRIQ and Avastin plus carboplatin and paclitaxel helped people with advanced non-squamous non-small cell lung cancer, or NSCLC, live significantly longer compared with Avastin plus carboplatin and paclitaxel.